Organization
INEZ DRUG STORE INC
Active
Other names
INEZ DRUG STORE INC
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE DICKERSON-GALER (OWNER)
(606) 298-3800
Entity
Organization
Contact information
Practice address
38 OLD MIDDLE FRK, INEZ, KY 41224
(606) 298-3800
(606) 298-3932
Mailing address
PO BOX 381, INEZ, KY 41224-0381
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P00517
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2028795
PK
—
05
—
54010053
—
KY
Enumeration date
09/13/2006
Last updated
06/16/2016
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